A Leap Forward in Options for Lung Cancer - Raymond N. DuBois, MD, PhD, Dean, College of Medicine - April, 2018
I can’t emphasize enough how important this discovery may be to the future of cancer medicine. In the United States, lung cancer is the leading cause of death by cancer. While lung cancer may develop in patients who are smokers, two out of three lung cancers develop in patients who have either quit smoking or never smoked in the first place. Worldwide, 1.6 million people die of lung cancer each year. If it is caught in its early stages and treated with standard of care surgery, radiation and/or chemotherapy, a little more than half of its victims will survive five years or more. However, if the cancer is found in its later stages after it returns and metastasizes, which it often does after treatment, the five-year survival rate is an abysmal five percent. As a result, metastatic disease is an enormous physical, emotional and economic burden in our society.
In their clinical trial, Rubinstein and Wrangle took advantage of potential synergy between two distinct classes of immunotherapy drugs. Cancer doctors have known that by deploying immunotherapy agents, mechanisms within the immune system can become activated to fight lung cancer. However, after a period of time following removal of the tumor, stray cancer cells will grow and increase, overwhelming the body’s natural defenses. Once the cancer progresses it will not stop on its own. In a clinical trial of 21 patients with metastatic non-small cell lung cancer, the MUSC team combined the checkpoint inhibitor, nivolumab, with a powerful new drug called ALT-803 that stimulates the immune system. Rubinstein co-discovered IL-15/IL-15Ra cytokine complexes during his postdoctoral studies at the Scripps Research Institute, a finding which led to the development of ALT-803. Expecting that in some patients the checkpoint inhibitor would stabilize the disease for a while, but that they would eventually develop resistance to the treatment, Wrangle and Rubinstein added ALT-803 to reactivate the immune system and mobilize lymphocytes against the tumors. Importantly, the MUSC team was able to deploy this novel combination in the outpatient setting, a place where cytokine therapies have previously been excluded due to extreme toxicity. The investigators’ results showed that nine of the 21 patients, or 45 percent, either experienced stabilization of their disease or had a partial response to treatment after receiving the combination therapy, but critically, the therapy was able to induce responses and clinical benefit in patients who had disease that was relapsed or refractory to standard immunotherapy.
Although this was a small clinical trial, it provides evidence of activity of a novel immunotherapy for lung cancer patients, and perhaps for future patients with other hard-to-treat cancers, as well. Re-induction of response to immunotherapy in metastatic lung cancer is an enormous leap forward in the field.
Please join me in congratulating Drs. Wrangle and Rubinstein on their early success, which speaks volumes about the power of collaboration and innovation in the advancement of medicine. To learn more about their work, I encourage you to check out the links below.
MUSC article on Drs. Wrangle & Rubinstein
Post & Courier article on clinical trial
Taking time to reflect on tangible progress - March 2018
Our strategic plan, Imagine MUSC 2020, is a journey. As with all journeys, it's important to pause, take a moment and reflect on on not only where you are headed, but how far you have come. To that end, we share some of our recent achievements related to the five goals of our stategy: Commit to Patients and Families First, Foster Innovative Education and Learning, Build Healthy Communities, Embrace Diversity and Inclusion, and Advance New Knowledge and Scientific Discoveries. Learn more about our goals and the recent accomplishments that follow in our Spring 2018 highlights document.
Shriners Hospitals for Children and MUSC Collaborating on Burn Unit - Letter of Intent signed to facilitate collaboration on development of a pediatric burn unit to be located within the new MUSC Shawn Jenkins Children’s Hospital.
MUSC Pain Rehabilitation Program – MUSC has launched the state’s first-ever pain rehabilitation program, an intensive, evidence-based program to serve all of SC and rehabilitate patients with chronic pain while tapering and eliminating opioid use.
Online Game Engages Students in Simulated Health Care Interprofessionalism – MUSC created a team-based “escape room” computer game to engage students to work together to solve clinically relevant issues. The game was introduced to over 700 students at MUSC’s Interprofessional Day, where students from different academic programs learn with, from, and about each other.
Science Communication Forum – MUSC hosted an enterprise-wide Science Communication Forum. The interactive event empowered researchers to advocate for their science with a variety of audiences including sponsors, policymakers, journalists, the public and other scientists.
MUSC Named among the Best Employers for Diversity in the U.S. - MUSC ranked No. 53 out of 250 organizations on the Forbes 2018 first-ever roster of America’s Best Employers for Diversity. In addition, MUSC ranked No. 6 out of 20 institutions in the education industry.
MUSC Earns Working Well’s Strategy for Wellbeing Platinum Award - MUSC was recognized by the South Carolina Hospital Association’s Working Well initiative for being one of the first organizations to achieve the Strategy for Wellbeing Platinum award for excellence in workplace wellbeing.
Charleston Medical District Greenway Phase 1 Launch - MUSC celebrated Phase 1 of the Greenway in collaboration with the City of Charleston, Roper Hospital and the Ralph H. Johnson VA Medical Center. With the thoughtful design of this space, it will create a live-learn community.
MUSC Recognized with Diversity Purchasing Award - MUSC Health was named Best New Program of the Carolinas by Virginia Supplier Diversity Council for contracting small-, minority-, and women-owned and businesses for the construction of the MUSC Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion.
MUSC and Clemson Partner to Design the Operating Room of the Future - A joint research team, including faculty from Clemson University and the Medical University of South Carolina, has unveiled a high-fidelity, mock operating room at the Clemson Design Center in Charleston. The goal of the project is to analyze every aspect of current operating rooms and redesign the standard with efficiency and improved patient care in mind.
MUSC Experts Play Role in Data-Driven Stroke Study with Striking Results - Statisticians at MUSC played a role in a study that found advances in brain imaging can identify more stroke patients who can receive therapy later than previously thought. Researchers call the results striking and say they will have immediate impact and save people from life-long disability or death.
Diversity and Inclusion Drive Population Health - David Louder, M.D., MBA, FAAP, executive director, MUSC Health Alliance
In the simplest of terms, “Population Health” is efforts to improve the overall health of specific groups of individuals. Who are these individuals and how are they included in our populations?
MUSC Health takes care of many populations. One focus could be patients from across South Carolina and beyond who come to MUSC Health for life-saving and life-changing specialty care. Another population would be Lowcountry residents in Charleston, Dorchester, and Berkeley counties who get all of their care, primary and specialty, through MUSC Health. And another population could be the folks who seem to come to our Emergency Room for all of their maladies.
Are these different populations? Yes! Will identical MUSC Health solutions solve their medical problems or sustain their health? Absolutely not. A unique part of population health compared to more traditional approaches is the focus on upstream, non-medical health factors, or social determinants of health. Our social workers are constantly addressing these and these can include – money for prescriptions, transportation to/from medical care, and homelessness.
Understanding differences in our patient populations is essential to creating the right solutions for our populations. For a moment, I want you to think about our Medicare ACO Population. These are Medicare patients who come to MUSC Health for their care; the majority live in Charleston County. What is the most common reason for a Medicare ACO patient to visit the MUSC Health Emergency Room? Chest Pain? No. Shortness of Breath? No. Abdominal Pain? No. Sickle Cell Crisis. Yes. That one bit of knowledge about Sickle Cell Anemia completely changes our approach to improve the health and reduce the emergency room usage of our ACO population.
“Our approach to diversity and inclusion as a MUSC Health team drives our openness to solve both medical and population health challenges. We see this in group visits where the patients become the teachers and shared problems and solutions improve outcomes as well as our own understanding of what is possible,” notes Philip Smeltzer, MUSC Health’s Program Administrator for Total Population Health. For example, an older adult with multiple chronic conditions is the best peer model for other seniors. Earlier in my career, the solution to reducing breastfeeding attrition was a diverse and inclusive peer support program (not more pediatricians).
Population Health is not “one size fits all.” Population Health delivery is also not “one size fits all.” Celebrate diversity. Create inclusiveness. We are better for our patients (and ourselves) when we do.
In honor of Martin Luther King, Jr. Day, on Tuesday of this week I attended the Charleston MLK breakfast meeting at the Gaillard Center. This is a wonderful event that brings together leaders from all professions and disciplines to strive towards racial understanding and economic equality. Prior to the program starting, we heard singing from Jared Wilder that really got us in the right mood for the upcoming agenda. Serving as Master of Ceremonies, Mayor Tecklenburg spoke positively about MUSC, citing how our institution was recently honored with the "Project of the Year" Award for the Southeast region from the National Association for Minority Contractors.
Other highlights of the program included a solo performance by the torch singer Jada Orr and a rousing speech by Joan Robinson-Berry, vice-president and general manager at Boeing SC. She started her speech by making everyone stand up and sing along with her, which set the mood for the day – namely, that this was going to be an event about unity rather than divisiveness. Ms. Robinson-Berry shared her life story with the audience, enumerating all of the obstacles she had to overcome in order to attain her goals and reach her current position in life. It was truly inspirational. She noted the need for more minority-owned businesses and more effective efforts to close the wage gap.
Kenetra Johnson from Clemson University delivered the Youth Address. She is from Hollywood, S.C., and shared her story and dreams, including her efforts as a student at the James Island Charter School to fight domestic violence.
Lastly, I was able to meet some of the attendees and socialize with individuals whom I rarely see during my hectic schedule at MUSC. It was a wonderful reminderthat there are so many opportunities to interact with key productive, creative and caring individuals in the Charleston area. My New Year's resolution for 2018 is to make those interactions happen more often, because I am both enriched and enlightened by them. Overall, the MLK breakfast meeting was a morning well spent sharing music, inspirational speeches and receiving a snapshot of some of the most inspirational and crucial parts of the Charleston culture.
I am thankful for this opportunity and look forward to more occasions like this in the future.
Commencement 2017: a celebration of six colleges producing innovative teaching and learning
Hundreds of friends and family members will join the board on May 19 in celebrating the successful matriculation of 650 new health care professionals into the next stage of their careers during the 2017 MUSC spring commencement ceremony. Graduates will represent all six MUSC colleges: Dental Medicine – 78; Graduate Studies – 49; Health Professions – 149; Medicine – 167; Nursing – 126; and Pharmacy – 81.
“Since June 2016, we will have graduated a record number of talented men and women – 1,016 students – from top-tier education and training programs during three graduation ceremonies,” Cole said. “Our board of trustees plays a central role in guiding and supporting our three-part mission of education, research and patient care, and they do it voluntarily often balancing very busy careers and personal responsibilities. We value the knowledge, experience and commitment of each trustee. We are always delighted and grateful when our board members participate in commencement, one of the most rewarding traditions of our academic year.”
Attached is a breakdown of graduates by college and demographics, including May, August and December ceremonies.
Wofford College President Emeritus Benjamin Dunlap, Ph.D., will deliver the commencement address and receive an honorary Doctor of Humane Letters degree. South Carolina State Sen. John Matthews Jr. of Orangeburg and Timothy Keating, senior vice president of government operations for The Boeing Company, will also receive honorary Doctor of Humane Letters degrees. Pamela Cipriano, Ph.D., RN, president of the American Nurses Association and a former administrator for MUSC, will receive an honorary Doctor of Science, honoris causa degree.
Collaborative Venture, Healthy Tri-County Initiative, Aligns Perfectly with MUSC's "Build Healthy Communities" Goal
The Healthy Tri-County initiative was officially launched at a breakfast event on Tuesday, January 31. This collaborative initiative will develop a regional health improvement plan through the integration of dozens of community health, outreach, education and other organizations.
This is a tangible an example of our Imagine MUSC 2020 goal of Build Healthy Communities, as well as our institutional charge to explore external partnerships. The launch also included the release of the Tri-County Community Health Landscape: Community Health Needs Assessment Report (CHNA). This report was a joint effort by the Trident United Way, Roper St. Francis and MUSC. Data from the CHNA survey will help health care providers and community organizations improve the overall health and wellness of our community, identify needs, establish priorities for programs and services, and inform strategies to address gaps between critical needs and services. For more information, or to obtain copies of the report, please reach out to Anton Gunn, chief diversity officer and executive director of community health innovation for MUSC Health, who served as MUSC lead on this project. You may access the digital version of the CHNA on the MUSC Health website at muschealth.org/chna.
Recent award is perfectly aligned with our goal to Foster Innovative Education and Learning
MUSC was recognized as a “leader in innovative learning” and named winner of a coveted Brandon Hall Group bronze award for excellence in the Best Launch of a Corporate Learning University category. Our award submission, “MUSC Creates a New Way to Explore Learning Opportunities”, was entered in collaboration with NetDimensions, MUSC’s new learning management platform. Albany Cromer, Learning Technologies Manager for MUSC Health explains, “Our objective was not simply to replace our learning management system, but rather to foster rich learning experiences.” Congratulations to everyone involved in a successful launch of a program perfectly aligned with our strategy for the future!
Another reason to embrace diversity? Discovering top talent, game changers and pure inspiration
Imagine MUSC 2020 is the strategic plan which is the roadmap for all the work we do at the Medical University of South Carolina. Our strategy is firmly rooted in five pillar goals, one of which is Embrace Diversity and Inclusion. The triumphant story of College of Medicine student, Domnique Newallo, is incredibly impactful and inspiring and is a true testament to the power and importance of nurturing the talent and providing the pathways for our future change makers to flourish and reach their potential. Domnique’s story of overcoming a seemingly endless barrage of obstacles is breathtaking. Her story serves not only to keep us laser-focused as an institution on the value of diversity, but also serves to let every other child, who ever felt the odds were stacked against her, know that anything is possible. Anything. Read about Domnique here.
A look at where we are...and where we're headed
A new academic year is here and progress continues as units across MUSC continue to align with Imagine MUSC 2020, our strategy for the future. 2015 was filled with events and communications raising awareness of our plan’s five goals of Commit First to Patients, Foster Innovative Education & Learning, Advance New Knowledge & Scientific Discoveries, Embrace Diversity & Inclusion, and Build Healthy Communities.
Within the past few months, important headway has been made that will propel us toward realizing our goals in a more deliberate way.
One of the key accelerators in moving us forward is the appointment of Darlene Shaw, Ph.D., to the new position of chief institutional strategy officer. In this role, Dr. Shaw adds to her duties as associate provost for educational affairs and student life, the responsibility of keeping Imagine MUSC 2020 plans, processes and progress on track. She is playing a critical role ensuring that as one MUSC, we are focused on integrating our three missions of education, research and clinical care, and aligning them with our five strategic goals.
Plans, even the best plans, are meaningless if not put into action. To that end, the Strategy Advisory Council (SAC) was chartered by President Cole and charged with ensuring successful implementation of Imagine MUSC 2020. The SAC will oversee strategy development, deployment, and accountability and is co-chaired by Darlene Shaw and Matt Wain, chief operating officer of MUSC Health. The SAC is also charged with developing a communications strategy to keep the MUSC family apprised of progress and to explain how each employee and student will play a role in the success of Imagine MUSC 2020.
In addition to the SAC providing guidance and accountability during our Imagine MUSC 2020 journey, each of the five goals of the plan has several prioritized initiatives which come underneath them. Each of those initiatives, 17 in all, has an executive champion, implementation team, and implementation team leader. Each implementation team is responsible for developing an action plan to achieve the initiative assigned to them. This structure will ensure our plan is not simply words on paper, but will become values in action that will truly change our organization and culture. Teams are being built and chartered this summer and an initial list of milestones -- an important way we will measure our success -- will be submitted by those teams by the end of September.
A new, redesigned Imagine MUSC 2020 website is under development and will be a hub for inspiring stories “connecting the dots” of what it means to weave the goals of Imagine MUSC 2020 through the work each of us does. It will also be the place where progress will be updated, upcoming events will be posted. A comprehensive communications plan will also be put into place, ensuring every pocket of MUSC is included and considered as we move forward.
While there is no start, nor end date to the culture we are building, this next phase of bringing Imagine MUSC 2020 to life is a great time to dig in and find your own personal way to get involved. It’s an exciting time to be at MUSC -- and imagine.